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Jishnu Das's avatar

yikes. I just re-read that comment and it is incomprehensible. Here is a conversation that may help.

Medical commission of Country X: There are too many C-sections in this hospital. We are going to recommend that doctors decrease C-sections.

Doctor in Hospital: We are more than happy to decrease C-sections. From now on, every time a patient comes in, we will call you and you should tell us whether to do a C-section.

Medical Commission: But that is not my job, that is yours.

Doctor: Yup. That is what we are doing. We keep telling you that our patients are different which is why we have so many C-sections.

(That's a real conversation, by the way)

I think this leads to a situation that cannot be resolved through argumentation. But,

Medical Commission: We are going to reduce how much you guys are paid for C-sections.

Researcher some months later shows that C-sections went down without any harm to mother or infants. Policy is kept in place.

It seems to me that shifting things back to a population-based policy is one way to get around the tricky issue of the reference class.

Am I completely off track on this? Apologies if unrelated to your course--I am intrigued by the connection to Meehl!

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Jishnu Das's avatar

I really wish I could take this course. One question: I am intrigued by your statement on how a sample-based view resolves the issues raised by Meehl (I have read your previous posts on this). I work in healthcare, and the usual response I receive from doctors on why they do not follow evidence-based guidelines is that their patients are `different.' I have always thought of this problem of the broken leg in Meehl as a question of the reference class, and have gradually arrived at the conclusion that the response `my patient is different' leads to the dead-end of a non-argumentable situation. In that, one could (not sure yet, how) formally show that the propositions `following the guidelines is good' and `I don't because my patients are different' cannot be resolved through argumentation. Consequently, to recover the value of a prediction metric, you are forced to move your recommendation back to population-based policy, instead of individual-level predictions, which is what Meehl was worried about?

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